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MALADII CONGENITALE

CARDIACE

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DATE EPIDEMIOLOGICE

5-20 de cazuri la 1.000 nn vii

Cele mai frecvente anomalii la om

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ETIOLOGIE

Factori genetici Aberaii cromozomiale

Multifactorial TORCH Factori de mediu

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EMBRIOLOGIE

Tubul cardiac prima lun (nn 10 mm)

Rotaie, segmentare, torsiune d-loopventral i la dreapta

Cordul n luna a doua Diviziune sinoatrial

- conotroncus

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CIRCULAIA FETAL

Rezistena vascular pulmonar mare Foramen ovale

Canalul arterial Canalul Arantius

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DIAGNOSTIC POZITIV

Anamneza Examen clinic

Investigaii paraclinice

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ANAMNEZA

Afeciuni materne Evaluare retardul creterii

- edeme- intoleran la efort- stridor- disfagie pentru solide

- sincopa

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EXAMEN CLINIC

Sindrom dismorfic malformaii asociate Tegumente Timp de recolorare capilar Degete hipocratice Edeme Puls Auscultaie Tensiunea arterial

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SINDROAME

Holt-Oram (Heart-Hand syndrome, is an inherited disorder characterizedby abnormalities of the upper limbs and heart(DSA,DSV) )

Turner (95% of individuals with Turner syndrome have both short stature andsigns of ovarian failure (no breast development by age 12 years or not started

menses)upon physical examination) Down (facies mongoloid,microgntie, hipotonie,o singura linie

palmara,macroglosie, gat scurt,pete albe pe iris,laxitate articulara accentuata, malfcardiace)

Marfan (arahnodactilie)

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INSPECIE - PALPARE

Deformare toracic oc apexian

Semn Harzer Freamt Puls periferic

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AUSCULTAIE

Zgomote I, II, III, IV Sufluri sistolice, diastolice, continuu -

localizare, iradiere Raluri

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INVESTIGAII PARACLINICE

Radiofgrafia standard Electrocardiograma

Fonocardiograma Ecocardiografia Cateterism

Angiografia

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ELECTROCARDIOGRAMA

Frecvena Tulburri de ritm

Axa electric Hipertrofii atriale, ventriculare Intervale PR, QRS, QT

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MALADII CU SHUNT STG-DR

Maladii potenial cianogene Inversarea shunt-ului Eisenmenger

Hipertensiune pulmonar Afeciuni defecte septale(DSA,DSV,canal A-V)

- persisten de canal arterial

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Defect septal interatrial

5-9% la nn 17-20% la adult Ostium primum 50%

Ostium secundum Sinus venos Clinic

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Canal atrio-ventricular

2-6% Sindrom Down

Asociere DSA, DSV, anomalii valvulare Clinic Radiologic

ECG deviere axial stng

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Persistena canalului arterial

12-15% - 25% n asocieri La prematuri 45-80%

Rubeola Istm aortic artera pulmonar stng 5-15 mm lungime, 6 mm grosime

Clinic Radiologic, ECG, Eco